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OBSERVATIONAL STUDY TO DEVELOP A TREATMENT–RELATED PATIENT-REPORTED OUTCOME MEASURE IN GAUCHER DISEASE (QOL-ONE PRO1G)
Author(s): ,
Maja Di Rocco
Affiliations:
Departments of Pediatrics and Neuroscience,Gaslini Institute,Genoa,Italy
,
Maria Domenica Cappellini
Affiliations:
Department of Clinical Sciences and Community Health,Università degli studi di Milano,Milan,Italy
,
Francesca Carubbi
Affiliations:
Department of Medicine, Endocrinology, Metabolism and Geriatrics, NOSE U.O. Medicina ad indirizzo metabolico-nutrizionistico,University of Modena and Reggio Emilia,Modena,Italy
,
Mirella Alpa
Affiliations:
Center of Research on Immunopathology and Rare Diseases (CMID), ,San Giovanni Bosco Hospital and University of Turin,Turin,Italy
,
Generoso Andria
Affiliations:
Department of Clinical Medicine and Surgery,Federico II University Medical School,Naples,Italy
,
Antonio Barbato
Affiliations:
Department of Clinical Medicine and Surgery,Federico II University Medical School,Naples,Italy
,
Alberto Burlina
Affiliations:
Unit of Metabolic Diseases,Azienda Ospedaliera Universitaria,Padua,Italy
,
Fiorina Giona
Affiliations:
Department of Cellular Biotechnologies and Hematology,Sapienza University,Rome,Italy
,
Gaetano Giuffrida
Affiliations:
Division of Hematology, Department of Clinical and Molecular Biomedicine,University of Catania, Ospedale Ferrarotto,Catania,Italy
,
Dario Roccatello
Affiliations:
Center of Research on Immunopathology and Rare Diseases (CMID),San Giovanni Bosco Hospital and University of Turin,Turin,Italy
,
Lorenza Maria Borin
Affiliations:
Department of Hematology,San Gerardo di Monza Hospital,Monza,Italy
,
Marco Spada
Affiliations:
Dipartimento di Scienze Pediatriche,A.O. Città della Salute e della Scienza di Torino - Ospedale Regina Margherita ,Turin,Italy
,
Francesco Papadia
Affiliations:
U.O.C. Malattie Metaboliche e Genetiche; D.A.I. Pediatria,Ospedale Pediatrico Giovanni XXIII,Bari,Italy
,
Silvia Linari
Affiliations:
Center for Bleeding Disorders and Coagulation,Careggi University Hospital,Florence,Italy
,
Sam Salek
Affiliations:
School of Life and Medical Sciences,University of Hertfordshire,Hatfield,United Kingdom
,
Tatyana Ionova
Affiliations:
National Medical Surgical Centre and Multinational Centre for Quality of Life Research,University Clinic, St.Petersburg State Universit,St. Petersburg,Rwanda
Esther Natalie Oliva
Affiliations:
Grande Ospedale Metropolitano Bianchi Melacrino Morelli,REGGIO CALABRIA,Italy
(Abstract release date: 05/17/18) EHA Library. Oliva E. 06/14/18; 216144; PB2398
Dr. Esther Oliva
Dr. Esther Oliva
Contributions
Abstract

Abstract: PB2398

Type: Publication Only

Background
Gaucher disease (GD) is a rare autosomal recessive lysosomal  disorder that results in the accumulation of sphingolipids in the body’s tissues due to glucocerebrosidase enzyme deficiency. GD manifests with vast clinical heterogeneity. Type 1 is the most common form (non neurophatic) with a wide spectrum of signs and symptoms at presentation: some are very mild, others may present variably enlarged liver and spleen which may cause abdominal discomfort. Trombocytopenia and anemia are very common at diagnosis and may be associated with signs and symptoms (bruising and bleeding, tiredness, vertigo, dyspnea and  reduced physical functioning). Over 20% of patients experience bone pain or fractures. Treatment is indicated for patients with type 1 GD who exhibit clinical signs and symptoms of the disease, including anemia, thrombocytopenia, skeletal disease, or visceromegaly. Assessment of the impact of illness on physical, mental, and social functioning is an essential element of clinical diagnosis, a major determinant of therapeutic choices and efficacy, and a guide to longer-term care. Furthermore, it is known that patient reported outcomes (PROs) may influence various changes in intervention. There are many generic instruments available to measure the impact of disease on patient’s health-related quality of life (HRQoL). However, there is no PRO measure that has been developed specifically for the use in GD. Such a measure would help clinicians to gain a more in-depth understanding of the impact of GD on patients and inform clinical decision making, leading to better patient care and compliance.

Aims

The aim of this study is to develop and validate an instrument designed to measure the impact of GD and treatment on individual patients’ PROs. Primary endpoints are the generation of items to construct a PRO instrument for patients with GD and its psychometric evaluation.

Methods

This is an observational multicentre study. Participants will be GD patients aged ≥ 18 years attending referral centers. The study will be divided in 6 stages: Stage 1 -  conceptualisation of PROs in GD patients before the data collection, in order to lay a conceptual foundation for the new instrument; Stage 2 - qualitative interviews; Stage 3 - item generation; Stage 4 - pre-testing; Stage 5 - item reduction; Stage 6 - validation of the final questionnaire. The total number of patients estimated to be assessed is approximately 100.

Results
The results of first stages of the study will be presented. The issues related to PROs of patients with GD will be researched and conceptualized. The interview guidance on HRQoL and symptom issues related to disease and its treatment will be developed and  the interviewer will conduct interviews in accordance with this guidance. Emerging themes on HRQoL and symptoms from the interviews will be reported and are expected to fall into the four main HRQoL domains - physical, social, environmental and psychological. Outcomes of qualitative interviews will be analyzed.

Conclusion
The user-friendly questionnaire to evaluate impact and symptoms of GD will meet the minimum standards set out by the FDA for PROs and HRQoL instruments that include intrinsic characteristics (reliability and validity), responsiveness, sensitivity to change in health states and adequate sample size (FDA Guidance, 2006; https://www.fda.gov/downloads/drugs/guidances/ucm193282.pdf). The instructions on the questionnaire will be easy to use, and the instrument will be short in length, self-explanatory, take a short time to complete, be easy to use and put minimal burden on the patient.

Session topic: 36. Quality of life, palliative care, ethics and health economics

Keyword(s): Gaucher disease, Outcome measurement, Patient, Quality of Life

Abstract: PB2398

Type: Publication Only

Background
Gaucher disease (GD) is a rare autosomal recessive lysosomal  disorder that results in the accumulation of sphingolipids in the body’s tissues due to glucocerebrosidase enzyme deficiency. GD manifests with vast clinical heterogeneity. Type 1 is the most common form (non neurophatic) with a wide spectrum of signs and symptoms at presentation: some are very mild, others may present variably enlarged liver and spleen which may cause abdominal discomfort. Trombocytopenia and anemia are very common at diagnosis and may be associated with signs and symptoms (bruising and bleeding, tiredness, vertigo, dyspnea and  reduced physical functioning). Over 20% of patients experience bone pain or fractures. Treatment is indicated for patients with type 1 GD who exhibit clinical signs and symptoms of the disease, including anemia, thrombocytopenia, skeletal disease, or visceromegaly. Assessment of the impact of illness on physical, mental, and social functioning is an essential element of clinical diagnosis, a major determinant of therapeutic choices and efficacy, and a guide to longer-term care. Furthermore, it is known that patient reported outcomes (PROs) may influence various changes in intervention. There are many generic instruments available to measure the impact of disease on patient’s health-related quality of life (HRQoL). However, there is no PRO measure that has been developed specifically for the use in GD. Such a measure would help clinicians to gain a more in-depth understanding of the impact of GD on patients and inform clinical decision making, leading to better patient care and compliance.

Aims

The aim of this study is to develop and validate an instrument designed to measure the impact of GD and treatment on individual patients’ PROs. Primary endpoints are the generation of items to construct a PRO instrument for patients with GD and its psychometric evaluation.

Methods

This is an observational multicentre study. Participants will be GD patients aged ≥ 18 years attending referral centers. The study will be divided in 6 stages: Stage 1 -  conceptualisation of PROs in GD patients before the data collection, in order to lay a conceptual foundation for the new instrument; Stage 2 - qualitative interviews; Stage 3 - item generation; Stage 4 - pre-testing; Stage 5 - item reduction; Stage 6 - validation of the final questionnaire. The total number of patients estimated to be assessed is approximately 100.

Results
The results of first stages of the study will be presented. The issues related to PROs of patients with GD will be researched and conceptualized. The interview guidance on HRQoL and symptom issues related to disease and its treatment will be developed and  the interviewer will conduct interviews in accordance with this guidance. Emerging themes on HRQoL and symptoms from the interviews will be reported and are expected to fall into the four main HRQoL domains - physical, social, environmental and psychological. Outcomes of qualitative interviews will be analyzed.

Conclusion
The user-friendly questionnaire to evaluate impact and symptoms of GD will meet the minimum standards set out by the FDA for PROs and HRQoL instruments that include intrinsic characteristics (reliability and validity), responsiveness, sensitivity to change in health states and adequate sample size (FDA Guidance, 2006; https://www.fda.gov/downloads/drugs/guidances/ucm193282.pdf). The instructions on the questionnaire will be easy to use, and the instrument will be short in length, self-explanatory, take a short time to complete, be easy to use and put minimal burden on the patient.

Session topic: 36. Quality of life, palliative care, ethics and health economics

Keyword(s): Gaucher disease, Outcome measurement, Patient, Quality of Life

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